[Electromyographic studies of myocutaneous sliding flaps for the covering of sacral decubitus ulcer]. / Elektromyographische Untersuchungen an myokutanen Verschiebelappen zur Deckung des sakralen Dekubitus.

Gluteus maximus myocutaneous sliding flaps from one or both sides are useful in covering deep, usually infected sacral pressure sores. Although skin is known to tolerate higher pressure in the covered area, muscle offers far better conditions for flap healing of infected defects. In spite of excellent early results, the long-term fate of the transposed muscle remains uncertain. An electromyography study was performed on eleven patients out of 29 with sliding gluteus maximus myocutaneous flaps in periods up to seven months after surgery. Our results show that signs of denervation parallel reinnervation and functional integrity of the transposed muscle.

Treating chronic hemiparesis with modified biofeedback.

Eleven patients with chronic spastic hemiparesis were treated with biosignal processing (BSP), a modified biofeedback method in which the patient practices useful tasks, not isolated individual movements. A surface EMG measures sequential movements, and an acoustic signal monitors muscle exertion. The patient first learns how the signal develops by using the unaffected limb. Then the patient tries to reproduce the course of the signal in the paretic limb. Patients received 12 to 30 treatments for upper and/or lower extremities. We measured maximum strength as expressed through the EMG signal; ability to perform the trained action as measured by specific grading systems; and general increase in movement competence during a Bobath movement test. Ten patients showed improved strength; four made marked progress in the performance of specific tasks with the upper extremity, as did four with the lower extremity. Four patients in each group improved in general movement. We recommend the integration of useful tasks into movement exercises in EMG biofeedback therapy.

[Preventive stabilization of the knee joint by a bandage (brace) in an ice hockey player. Sense or nonsense?]. / Prophylaktische Stabilisierung des Kniegelenkes durch Bandage (Brace) beim Eishockeyspieler. Sinn oder Unsinn?

Braces for the knee are used by more and more First League Players to prevent injury to the knee, whether or not the knee has been injured previously. One player of the National Team wearing braces since last season complained of restricted efficiency. Electromyographical examination of his thigh muscles showed severe neurogenic changes. We concluded to refuse that so-called preventive braces.

[Ultradian periodicity, diurnal and circannual rhythms in the electroencephalogram]. / Ultradiane Periodik, Tages- und Jahresrhythmen im Elektroenzephalogramm.

The cerebral rhythms depictable by the EEG show fluctuations with several characteristic periodicities. The ultradian region with a range from several seconds to 20 hours is divided into three sections. Pathological and physiological EEG-characteristics are influenced by physiological rhythms of 2-100 seconds. The EEG-complexes occurring with panencephalitis are dependent on breath frequency. Grouped dysrhythmias correlate with higher order blood pressure waves. Systematic changes of the basal activity caused by slow variations of direct voltage have been conjectured by Aladzhalova (1964) and confirmed by spectral analysis (K unkel et al. 1969). Periods of 60-140 minutes with a medium cycle of approximately 90 minutes are typical for sleep, the phases of which are shown by the EEG and the recording of rapid eye movements (REM). THe periodicity corresponding to the basic rest activity cycle can also be shown on the EEG in a state of awakeness . Diurnal studies between sunrise and sunset showed frequency variations of some pathological EEG characteristics. The frequency of abnormal rhythms increased evenly from 8 am to 3.8% to 3 pm to 9.5%. Grouped dysrhythmias showed similar effects. As far as basal activity is concerned the occurrence of a diurnal peak of measurements in the alpha range and their maxima in the high frequency ultradian regions was noticeable. Circadian studies with a periodicity of 24 (plus/minus 4) hours showed that the diurnal maxima of all frequency ranges occurred almost simultaneously, however, they contained temporal shifts due to their specific structure. The major pertinent differences were shown by frontal and temporobasal cerebral areas. Circadian studies of sleep phases of primates showed a maximum for delta activity at 1 am and for theta activity at 5 am. As expected, circannual rhythms of hibernating animals can be observed on the EEG, they have also been discovered with humans be means of EEG measurements: by visually analyzing EEG results, systematic differences in the frequency of types of basal activity were noticed. Thus, Beta-EEGs with a medium frequency of 14% occurred in May with the frequency of Alpha-EEGs fluctuated in inverse proportion and was at its peak during summer. Conspicuous among pathological EEG characteristics were grouped dysrhythmias that occurred about twice as often in summer as in winter. No generally valid cause can be assumed for the variety of rhythms.

[Circadian, infradian and seasonal changes in neural conduction velocity with reference to the effects of temperature. II: Infradian and seasonal changes]. / Tageszeitliche, mehrtägige und jahreszeitliche Veränderungen der Nervenleitgeschwindigkeit unter Berücksichtigung von Temperatureinflüssen. Teil II: Mehrtägige und jahreszeitliche Veränderungen.

Using the longitudinal study it was shown that a number of sensory neurographic parameters changed systematically throughout the 4-day investigation. In particular the sensory NCV of the n. medianus of the hand increased significantly. Possible causes i.e. the activation of the metabolism are discussed. Should this assumption prove to be true repetitive stimulation of a nerve could have a therapeutic effect. The seasonal influences are displayed using the results of a cross-sectional study. Six out of 21 neurographic parameters showed significant seasonal variations. In the NCVs of the n. medianus and the n. ulnaris maxima were present in summer and autumn while the NCVs of the lower extremities had minima. In winter and spring differences between the NCVs of the lower and upper arm and leg were lowest. These differences may be caused by seasonal changes of the metabolism which modifies the coefficient of the temperature of the neurographic parameters.

[Circadian, infradian and seasonal changes in neural conduction velocity with reference to effects of temperature; I.: Circadian rhythm]. / Tageszeitliche, mehrtägige und jahreszeitliche Veränderungen der Nervenleitgeschwindigkeit unter Berücksichtigung von Temperatureinflüssen; Teil I.: Tagesrhythmik.

Using results of two collectives (one cross-section study covering 212 individuals and a longitudinal study of 10 individuals over a period of 4 days with 4 examinations/individual/day) circadian, infradian and seasonal influences on the changes observed are considered. The skin temperatures displayed significant circadian variations subsequent to electrical stimulation in 4 of 5 topographic regions from which the measurements were performed. Before stimulation in only one of five regions significant circadian changes were observed. Thus stimulation caused an increase in amplitude but no changes in phase. Pre- and post-stimulation rhythms were in phase. There was found a two-peaked circadian rhythm with maxima at late noon and at midnight. Probably there were systematic differences in skin temperature in the upper extremities compared to the lower ones. The latter showed a minimum in the early morning hours. The circadian effects are presented almost completely free of temperature influences for the sensory NCV of the n. medianus on the hand. As opposed to the simultaneously acquired 2-peaked circadian rhythm of the skin temperature an almost continuous decrease in the NCV can be observed from the early morning until midnight. After midnight there was an abrupt increase of the NCV by about 5%. The significant influences of the time-of-day on the NCV of the upper- and lower-arm could not be attained independent of temperature influences. It was nonetheless apparent that the motor and sensory NCV of the lower arm increased throughout the day in contrast to the NCV of the hand. Possibly, local' influences interfered thereby with the autonomic rhythm of the nerve.

[Annual rhythms in frequency of electroencephalographic patterns (author's transl)]. / Jahresrhythmen der Häufigkeit elektroenzephalographischer Merkmale.

A series of electroencephalographic features were measured for about 11,500 patients from a clinical population, over a period of five years (1972 to 1976) and were documented using a standarized procedure. It could be shown that for males a definite yearly rhythm was present for the relative frequencies of alpha-type, partial beta-type, and low voltage EEGs, as well as for continuous and grouped dysrhythmias, the amplitudes of which were in the main 20--30% of the average. For females on the other hand, apart from grouped dysrhythmias, no such yearly rhythms could be proven, at the most such with a periodicity of between 14 and 16 months. The data often display trends that are more distinct than the rhythmicity and as such these should be taken into consideration when deciding upon the model used for statistical regression.